Thanks for offering!
Well, I’m currently at a private practice and and have learned from experience how cut throat contract and financial negotiations can be. This is my 3rd practice. I have learned that certain owners just don’t want a partner(even though they promise this), instead they want a workhorse doing procedures all day for a salary. I’ll tell you, I work hard, but also now understand when to cut my loses.
With that in mind, it’s hard to ask about what is a relevant topic unless I’m in the midst of a scenario.
I will say, the “contract gotchas” definitely raised an eyebrow. Besides non-competes(which are discussed to death) maybe there are other ones that you may consider valuable?
A few high level thoughts
-Indemnification: Always have an attorney review this section. You’ll want it to be mutual and make sure it is not too strong. Basically this means you’d hold your “boss”/partner harmless from any expenses incurred that may not be covered by your malpractice policy, generally for your misconduct. Indemnification language is pretty standard in many independent contractor arrangements when you carry your own malpractice but is sometimes part of employment agreements as well. Depending on language, if your boss is named in an action (a patient alleges you sexually harassed them or alleged you seemed impaired when you botched a procedure), there’s an argument you need to pay your bosses legal bills. You’ll want to make sure it’s not too overbearing and cuts both ways (Mutual indemnification)
Non disparagement clause: let’s say you and your boss are oil and water and it doesn’t work out unrelated to your clinical aptitude. This prevents him from badmouthing you to the hospital CEO impacting your future employment
-Intellectual property language: Make sure it’s clear who owns “what”. If you write a book during your off hours or develop a device on your garage- that should belong to you and not your employer. However if you are developing something during work hours with your employer’s resources/staff/supplies, your employer may have a right to the profits from it (surgeons/proceduralists tend to make the biggest deal out this)
If you are precepting a resident or student, that can slow you down a bit and impact your collections. Your employer may be reimbursed for this from the university- try to get a cut of that money (generally paid hourly or as a stipend) to make you “whole” for the extra time spent between patients explaining things to a student
Since you are paid on collections you are at risk for payer mix and rev cycle performance, both of which are generally outside your control. Consider some high level performance metrics to hold your employer to In order to ensure you aren’t negatively Impacted if they botch revenue cycle. Make sure you have the right to audit/have ready access to your financial data. For instance if you consistently are seeing 100 patients per week and your paycheck all of a sudden drops 20% you have a right to investigate to figure out why. Also hard code in your contract that you’ll receive monthly detailed financial statements of your activity to ensure you are actually being paid what you are entitled to (if you are paid 50% of collections, make sure that matches the monthly reports/aren’t any errors)
malpractice: make sure it’s crystal clear whether you have a claims based or occurance based policy if employer is providing coverage. Your tail should be roughly 2x your annual premium unless you have a big loss history. I’ve seen some physicians resign and not aware they are responsible for their own tail and are in a bind. We (My health system) sometimes reimburse independent contractors for their malpractice premiums if they exclusively practice within our facilities
you referenced non compete but non solicitation is also important- read that section carefully- it may prevents you from bringing staff with you if you leave or having contact with your former patients to recruit them to your new site. If you want to start up your own practice outside your non compete radius, it prevents you from mailing a letter to patients or contacting them directly
CME/licenses/med staff dues: see if your employer will pay for this, as they are required for you to do your job. My health system pays generally $5k per year as a point of reference
those are a few thoughts- hope they are helpful. Wrote this on my phone so excuse the awful grammar
